I just don’t get it.

I attended a birth on Wednesday. It all went well. I think she was satisfied and informed and is totally in love with her new baby boy. It was good. This woman did receive her fair amount of interventions, but she seem completely content with them at each step of the way. This morning we had a visit and she felt that everything went as well as it could and didn’t think she would have changed a thing (she wasn’t anti-intervention, really, but I thought she’d have liked to stall more on some things). So yay! That’s what it’s all about, right? Also, zero complications with mama and baby, which was really nice to see considering that my other two clients both had some emergent situation towards the end (precipitated by what, I’ll never know…). The moment of birth is magical, for sure, and it was a privilege to be there for them on such an amazing day.
Aside from the doula portion, just the experience of the hospital is really crazy to me. I just can’t for the life of me understand some of this stuff. It’s all so invasive and rushed. Doctors say things that are untrue- or at least are based in untruth. For instance, with the last birth I attended we had to continually bargain our way out of pitocin. My client was at 8cm (and had been for an hour) and was having strong, piggybacking contractions. They came in and said "It’s not anything you’re doing wrong, but for some reason your contractions aren’t doing the job that they are supposed to…" It’s stuff like this that makes me want to burst out of my peaceful doula role and say "Well how the hell do you think her cervix has been dilating? huh?" I also went on the hospital tour with this particular client, and the nurse told the group that the reason they don’t allow food during labor is because you actually aren’t able to digest it… Uhm. No. That’s not why, and it’s not even true. I also happen to know that her doctor was actually irritated that my client didn’t want an epidural (she was talking about it in the hallway and my nurse friend overheard). What is that about?
With this birth in particular, there were a few things that stood out. First, they started her on pitocin from the get-go, and had her convinced that her labor was already taking too long. They also didn’t really listen to her when she said she didn’t want more pain meds towards the end- upping her pit and sending in the nurse anesthetist anyway (at which point she was overcome again and didn’t care). They fed her lines about her contractions not being strong enough to "do anything" and her labor needing to move along (for the record, she was admitted at 3:30am at 3cm and baby was born exactly 12 hours later). They also basically ignored her desire to try pushing in different positions and just kind of swept in and put the bed back and lifted her legs up. They also forgot that she wanted to wait to cut the cord until is stopped pulsating and cut it immediately. They were (to me) very aggressive about the delivery of the placenta at the end, giving her more pitocin to get it going just moments after the birth and pushing on her tender belly. At the very end, it’s all going so fast- I just want them to take a minute to give her an option and let her know what they are doing!

I don’t mean to sound like such a rookie- I know this is common procedure and my client didn’t take issue with any of it. I’m a new doula, but I do a lot of research and have heard my fair share of stories. The thing is- this was so mild compared to my experience of the doctors with my other two births… I just end up feeling like we narrowly escaped some disaster this time- and I resent feeling that way. I also end up feeling SO lucky that I chose to have a homebirth- both because I really think I would have faced lots of intervention and bargaining out of things (44 hours of labor is probably not acceptable to them…), and also because it gives me fresh eyes while I’m a witness to the system. This model of care is SO DIFFERENT from what I experienced with my midwife. In many ways it leaves me questioning motives and feeling utterly confused. I don’t want to think of these doctors in this way, and of course there are many exceptions, but sometimes it’s really hard not to see many of them as detached and bored, unable to question their way of doing things.

I think the thing that I dislike the most about this model of care is the notion that women can’t birth on their own and that their bodies are somehow faulty. They never explain why they are adhering to this timeline for "progress" and why it means that the cervix has to so steadily dilate, or why a woman’s instincts are so frequently wrong to them. I can’t tell you how often I read some new mama’s reflection on her birth where she says something like "My pelvis was too small" or "I couldn’t dilate" or something about how her baby was somehow saved. That kind of thing always makes me wonder what kinds of interventions were in place before those conditions came about, because I can’t accept that so many women grow babies that they can’t naturally birth.

This is nothing new to me, but it frustrates and confuses me to no end. I really do see the need for doulas and birth educators and just people who will help to empower women and their families. I feel like I’m doing important work. However, I can’t for the life of me understand so much of what’s going on at the other end. I truly hope that we are on the cusp of some revelatory change in the birth world (at least in the US), but until then I am left to wonder why so much is still broken in spite of all the knowledge at our fingertips. 


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